Takura Tomoyuki, Fujiya Mikihiro, Shimada Yasuhiro, Kohgo Yutaka
Department of Health Care Economics and Industrial Policy, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Japan.
Int J Clin Oncol. 2016 Aug;21(4):633-641. doi: 10.1007/s10147-015-0932-2. Epub 2015 Dec 14.
Few reports have thus far discussed the influence of economic factors on treatment decision-making by patients. The objective of the present study was to clarify the awareness among oncologists of health economics in cancer treatment.
The present study was based on the questionnaire regarding health economics in cancer treatment carried out by the Japan Society of Clinical Oncology (JSCO) in July 2013. The subjects were trustees registered with JSCO. The survey investigated the influence of medical expenses on patient access to and selection of medical treatment in order to clarify the primary attributes of the respondents and their awareness of economics. The study also investigated the maximum allowable public medical expenses to prolong the life expectancy of a cancer patient by 1 year and the factors that can influence treatment selection.
The 172 respondents had completed a mean of 30.3 ± 6.2 postgraduate years, and the mean number of patients they treated annually was 1323 ± 1963. The degree of treatment accessibility among patients was perceived positively by 112 (71.3 %) and negatively by 49 (28.7 %) of the respondents, irrespective of medical expenses. Of the 172 respondents, 66 (41.0 %) believed that the maximum allowable medical expenses for cancer treatment should be ≤4 million yen/LY, with 62 (39.8 %) reporting a value of 4.01-8 million yen/LY.
The findings of this study suggest that a certain range of medical expenses has come to be regarded as the standard range of medical expenses for cancer treatment among oncologists, with answers based on the premise that patients should have access to effective medical treatment.
迄今为止，很少有报告讨论经济因素对患者治疗决策的影响。本研究的目的是明确肿瘤学家对癌症治疗中卫生经济学的认识。
本研究基于日本临床肿瘤学会（JSCO）于2013年7月进行的关于癌症治疗中卫生经济学的问卷调查。研究对象为在JSCO注册的受托人。该调查研究了医疗费用对患者获得和选择治疗的影响，以明确受访者的主要特征及其经济学意识。该研究还调查了将癌症患者预期寿命延长1年的最高可允许公共医疗费用以及可能影响治疗选择的因素。
172名受访者的研究生学历平均为30.3±6.2年，他们每年平均治疗的患者数量为1323±1963名。无论医疗费用如何，112名（71.3%）受访者对患者获得治疗的程度持积极看法，49名（28.7%）持消极看法。在172名受访者中，66名（41.0%）认为癌症治疗的最高可允许医疗费用应≤400万日元/生命年，62名（39.8%）报告的数值为401 - 800万日元/生命年。
本研究结果表明，在肿瘤学家中，一定范围的医疗费用已被视为癌症治疗的医疗费用标准范围，其答案基于患者应能获得有效治疗这一前提。
